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North Carolina News: Item 2127 - Physician Self-Prescribing, Prescribing for Family Members, and Prescribing by Retired Physicians
Reprinted from the October 2006 North Carolina Board of Pharmacy Newsletter.
Board staff are frequently asked whether or not, and under what circumstances, a physician may self-prescribe, prescribe for family members, or prescribe after retirement. The North Carolina Medical Board has specific policies to deal with each of these circumstances.
Self-treatment and treatment of
family members and others with whom
significant emotional relationships exist.*
It is the position of the North Carolina Medical Board that, except for minor illnesses and emergencies, physicians should not treat, medically or surgically, or prescribe for themselves, their family members, or others with whom they have significant emotional relationships. The Medical Board strongly believes that such treatment and prescribing practices are inappropriate and may result in less than optimal care being provided. A variety of factors, including personal feelings and attitudes that will inevitably affect judgment, will compromise the objectivity of the physician and make the delivery of sound medical care problematic in such situations, while real patient autonomy and informed consent may be sacrificed.
When a minor illness or emergency requires self-treatment or treatment of a family member or other person with whom the physician has a significant emotional relationship, the physician must prepare and keep a proper written record of that treatment, including, but not limited to, prescriptions written and the medical indications for them. Record keeping is too frequently neglected when physicians manage such cases.
The Medical Board expects physicians to delegate the medical and surgical care of themselves, their families, and those with whom they have significant emotional relationships to one or more of their colleagues in order to ensure appropriate and objective care is provided and to avoid misunderstandings related to their prescribing practices.
(Adopted May 1991)
(Amended May 1996; May 2000; March 2002; September 2005)
The Retired Physician
The retirement of a physician is defined by the North Carolina Medical Board as the total and complete cessation of the practice of medicine and/or surgery by the physician in any form or setting. According to the Medical Board’s definition, the retired physician is not required to maintain a currently registered license and shall not:
provide patient services;
order tests or therapies;
prescribe, dispense, or administer drugs;
perform any other medical and/or surgical acts; or
receive income from the provision of medical and/or surgical services performed following retirement.
The North Carolina Medical Board is aware that a number of physicians consider themselves “retired,” but still hold a currently registered medical license (full, volunteer, or limited) and provide professional, medical, and/or surgical services to patients on a regular or occasional basis. Such physicians customarily serve the needs of previous patients, friends, nursing home residents, free clinics, emergency rooms, community health programs, etc. The Medical Board commends those physicians for their willingness to continue service following “retirement,” but it recognizes such service is not the “complete cessation of the practice of medicine” and therefore must be joined with an undiminished awareness of professional responsibility. That responsibility means that such physicians should:
practice within their areas of professional competence;
prepare and keep medical records in accord with good professional practice; and
meet the Medical Board’s continuing medical education
requirement.
The Medical Board also reminds “retired” physicians with currently registered licenses that all federal and state laws and rules relating to the practice of medicine and/or surgery apply to them, that the position statements of the Medical Board are as relevant to them as to physicians in full and regular practice, and that they continue to be subject to the risks of liability for any medical and/or surgical acts they perform.
(Adopted January 1997) (Amended January 2001)
Pharmacists must, of course, apply their professional judgment when choosing whether or not to fill any prescription. The Board of Pharmacy encourages any pharmacist who is concerned about the prescribing habits of a particular physician to first discuss those concerns in a professional manner with the physician. Reference to the above Medical Board policies may facilitate that discussion. If such discussion does not resolve any perceived problem, the pharmacists should contact the Board of Pharmacy, Medical Board, or both.
